Telephone Representative - Canton, MA

+ Telephone Representative reports directly to the Director of Policy Administration. + Under limited supervision, handles a variety of customer service inquiries and problems on the telephone from policy owners and agents. ...

All Boston Mutual employees who interact with our policyholders, our producers, and our BML associates embrace the principles of our brand and service philosophy.  We are all brand ambassadors.  Both our words and our behaviors matter.  We share a common service philosophy and pr ...

The Telephone Representative reports directly to the Director of Policy Administration. The position involves handling customer service inquiries and problems on the telephone from policy owners and agents. · Under limited supervision, handles a variety of customer service inquir ...

+ Under the direction of the Precertification Team Manager, the UM Specialist is responsible for coordination of coverage determinations + + Key Responsibilities/Duties: writes denial letters for medical necessity + participates in training program + conducts staff audits + assis ...

Supervises Security Officers across one or more client posts; ensures post orders are followed and required reports are submitted. · Responds to emergencies by notifying appropriate authorities and client representatives. · Coaches and disciplines staff as appropriate; consults w ...

The Worksite Billing Support Representative is responsible for the successful processing of administrative transaction requests using a number of processes and systems while maintaining the highest levels of service professionalism in all they do. · High School Diploma required. ...

The Assistant General Counsel will protect the combined Harvard Pilgrim Health Care and Tufts Health Plan organization's legal interest for Point32Health and maintain its operations within the scope established by law. · ...

A Care Manager – Nursing Field (RN CM) will ensure that all members receive timely care management across the continuum. The nurse care manager possesses strong clinical knowledge and ability to facilitate a care plan which ensures quality medical care for the member. · Perform t ...

The Assistant Security Manager supervises security officers and ensures that post orders are followed. They respond to emergencies, coach and discipline staff as needed, and train security officers on post orders and assignment details. · ...

The UM Specialist is responsible for daily management of non-clinical reviews supporting clinical business program related work of Utilization Management department. · ...

We are currently looking for an Appeals and Grievance Analyst to join our team at Point32Health. As an Appeals and Grievance Analyst you will be responsible for managing member appeals and grievances in accordance with State and Federal regulations. · You will work collaborativel ...

The Appeals Analyst role at Point32Health involves professional management and coordination of member appeals and grievances under State and Federal regulations. This position requires superior customer service skills, benefit interpretation knowledge, and ability to work indepen ...

Job summaryUnder the general direction of the Member Appeals and Grievance Supervisor appeals analyst responsible per State and Federal regulations for professional management coordination of assigned member appeals grievances received by Point32Health. · ...

Under the supervision of the Utilization Management Supervisor, the Behavioral Health (BH) Utilization Management (UM) Clinician is responsible for conducting benefit coverage reviews and utilization management according to applicable regulatory guidelines and Enterprise contract ...

We enjoy the important work we do every day in service to our members, partners, colleagues and communities. · The Supervisor is responsible for maintaining up-to-date knowledge of Point32Health products and communicating changes to staff. · Providing accurate and thorough interp ...

Under the general direction of the Manager, · The Supervisor of member Services is responsible for · Maintaining up-to-date knowledge of Point32Health products. · ...

The Director of Configuration and Operations of the claim adjudication systems drives configuration strategy and execution ensuring accurate setup of claims adjudication products benefits payment processes and automation of business processes. · Hires manages trains both direct n ...

The Program Manager II is responsible for projects and initiatives with significant cross-functional interface that support the Point32Health MHP program. · Manage ongoing assigned program operations and/or vendors. · ...

The Salvation Army's Divisional Headquarters Is Hiring a Social Ministries Assistant And Offers The Following Benefit Package To Part-time Employees. · Generous paid time off every year that includes: holidays, vacation time and sick time · Employer funded Pension Plan (company ...

Under the oversight of the Director, · Behavioral Health, the Manager, · Behavioral Health is responsible for leading at least one · Behavioral Health functional team. · ...